Cancer Incidence in the Kurdistan Region of Iraq: Results of a Seven-Year Cancer Registration in Erbil and Duhok Governorates

Role of Healthy Lifestyle and Diet Quality in the Development of Colorectal Cancer in the Adult Population in the Kurdistan Region: A Case-Control Study

Background The incidence of colorectal cancer (CRC) is increasing in developing countries. The factors contributing to the risk of CRC are not known in developing countries. Therefore, this study aimed to explore the role of a healthy lifestyle on CRC in the adult population in the Kurdistan Region of Iraq. Methodology In this case-control investigation, patients previously diagnosed with CRC were included as cases (n = 84) and the healthy adult population as healthy controls (n = 87). The patients were selected from the Gastroenterology Unit of Azadi Teaching Hospital and Emergency Teaching Hospital. The healthy controls were selected from the caregivers of patients who met the eligibility criteria. Results Individuals with a history of chronic disease (63.08% vs. 40.52%; p = 0.0043), a history of hypertension (71.74% vs. 40.80%; p = 0.0003), and a history of inflammatory bowel disease (IBD) (59.42% vs. 42.16%; p = 0.0267) had a significantly higher prevalence of CRC compared to healthy controls. CRC patients had significantly lower diet quality scores than healthy controls (36.27 vs. 37.83; p = 0.0002). The study showed that CRC patients had a significantly lower lifestyle index score compared to healthy controls (10.20 vs. 11.69; p = 0.0002). In addition, CRC patients had lower scores for diet (0.42 vs. 1.00; p < 0.0001), smoking (2.92 vs. 4.0; p < 0.0001), and physical activity (1.02 vs. 1.70; p < 0.0001) compared to healthy controls. However, CRC patients and healthy controls had similar alcohol index scores (5.0 vs. 530; p = 1.000) and body mass index (1.04 vs. 1.01; p = 0.8982). Conclusions This study showed that CRC was associated with having a history of bad diet quality and unhealthy lifestyles. In addition, a history of chronic diseases, hypertension, and IBD was associated with the risk of CRC.

NOS3 and CTH gene mutations as new molecular markers for detection of lung adenocarcinoma

Gene mutations can contribute to lung adenocarcinoma (LUAD) development, metastasis, and therapy. This study aims to identify mutations in the endothelial nitric oxide synthase (eNOS or NOS3) and cystathionine γ-lyase (CSE or CTH) genes that are connected to LUAD symptoms. Two gene polymorphisms were identified using Sanger sequencing in 31 LUAD patients' formalin-fixed paraffin-embedded (FFPE) tissues. Epidermal growth factor receptor (EGFR) mutation and programmed death-ligand 1 (PD-L1) expression were examined in 110 LUAD patients using real-time polymerase chain reaction and immunohistochemistry. Mutations in the selected genes were retrieved from the gnomAD database for all cancer types and the Mutagene and COSMIC databases for LUAD patients. The GeneMANIA prediction server was used to predict the interaction between the studied genes. Poorly and moderately differentiated tumours predominated, with pT3 N2 Mx being the most prevalent stage. Polymorphism data showed 189 NOS3 gene mutations and 34 CTH gene mutations. In 110 LUAD patients, 14 (12.73%) were PD-L1 positive and expressed 50% or more protein. Eight (7.27%) samples included EGFR mutations, including two deletions and two point mutations in exon 19, four point mutations in exon 21. In gnomAD, 4012 NOS3 mutations and 1214 CTH mutations are present. In the Mutagene and COSMIC databases, the NOS3 gene had 295 and 93 mutations, whereas the CTH gene had 61 and 36. According to the GeneMANIA prediction server, 10 genes are related to NOS3, eight with CTH, 15 with EGFR, and 5 with PD-L1. This study is the first to identify several previously unknown mutations in LUAD patients' NOS3 and CTH genes, with potential therapeutic implications.

Upregulation of XRCC1 DNA Repair Gene, Interleukin-8, and Bcl-2 Antiapoptotic Gene Levels in Kurdish Patients with Gastric Adenocarcinoma

Gastric cancer (GC) is one of the deadliest tumors due to its competence to invade and metastasize. The DNA repair gene (XRCC1), interleukin-8 (IL-8) gene, and B-cell lymphoma 2 (Bcl-2) gene play a crucial role in the development and progression of GC. This study aimed to evaluate the expression of these target genes in GC patients in the Kurdistan region of Iraq. Gastric cancer tissues were collected from 29 patients diagnosed with gastric adenocarcinoma that underwent gastric resection, and 21 tissue samples were obtained from healthy patients that underwent gastroscopy. The gastric tissues were collected in different hospitals in Erbil and Sulaymaniyah cities in the Kurdistan region of Iraq. Moreover, the data regarding Helicobacter pylori, age, gender, and stage of the disease were recorded and analyzed using GraphPad Prism. The gene expression levels of XRCC1, IL-8, and Bcl-2 from gastric tissue were studied by real-time quantitative polymerase chain reaction. The results showed that H. pylori infection was equally distributed among males and females in the tissues of gastric patients, while most of the H. pylori-negative patients were females. It is also found that gastric patients aged 30-60 years old are more commonly tested for the H. pylori test. Accordingly, in this study, patients diagnosed with gastric inflammation more often tested positive for H. pylori, while patients diagnosed with gastric cancer tested negative for this infection. Additionally, it was found that the target genes (XRCC1, IL-8, and Bcl-2) were significantly upregulated in GC patients, compared to the healthy group. Finally, the result revealed that XRCC1, IL-8, and Bcl-2 were upregulated in the Kurdish patients with GC, compared to the healthy control group. Targeting XRCC1, IL-8, and Bcl-2 genes can be an interesting field and promising strategy for cancer treatment.

Detection of IL-1β, VEGF and IL-4 with their novel genetic variations in breast cancer patients

Interleukin-1β (IL-1β), vascular endothelial growth factor (VEGF), and IL-4 serum levels and new genetic mutations in breast cancer (BC) patients were assessed in the current study. The serum levels of the examined cytokines in 40 BC patients and 40 control subjects were assessed using the ELISA technique. In order to identify genotype variants of the IL-1β, IL-4, and VEGF genes in 40 Formalin Fixed Paraffin Embedded (FFPE) samples with BC and 10 FFPE samples from healthy women's breast tissue, Sanger sequencing was used. According to this study, BC patients had significantly lower serum concentrations of IL-4 and significantly higher quantities of the tumor markers, CA15-3, IL-1β, and VEGF. In terms of genotype alterations, a total of 21 mutations in three trialed genes (eight in IL-1β, 10 in IL-4, and three in VEGF) were found in BC patients. The results of the current investigation suggested that angiogenesis and the development of BC may be significantly influenced by the genetic differences and higher levels of the examined cytokines.

Survival Analysis of Oncological Patients Using Machine Learning Method

Currently, a considerable volume of information is collected and stored by large health institutions. These data come from medical records and hospital records, and the Hospital Cancer Registry is a database for integrating data from hospitals throughout Iraq. The data mining (DM) technique provides knowledge previously not visible in the database and can be used to predict trends or describe characteristics of the past. DM methods can include classification, generalisation, characterisation, clustering, association, evolution, pattern discovery, data visualisation, and rule-guided mining techniques to perform survival analyses that take into account all the patient's medical record variables. For four of the eleven groups examined, this accuracy was relatively high. The database of patients treated by the Baghdad Teaching Hospital between 2018 and 2021 was examined using a classification of the most crucial variables for event prediction, and a distinctive pattern was found. Machine learning techniques allow a global assessment of the data that is available and produce results that can be interpreted as significant information for epidemiological studies, even in cases where the sample is small and there is a lack of information on several variables.